Timisoara Medical Journal

The article provides an extensive analysis of the data obtained in bioequivalence studies, which can be considered for further evaluation in the development of general and individual therapeutic regimens. Concrete data obtained in two bioequivalence studies compared amiodarone formulations and included plasma levels of amiodarone and the active metabolite desethylamiodarone. The analysis included mean data and variability in plasma concentrations and pharmacokinetic parameters. In addition, a global and structural meta-analysis of the individual plasma level sets was performed. The half-life of amiodarone was not well defined and the total area below the plasma level curves was less appropriate for estimating bioequivalence. Full article

(1) Background: Infection with Echinococcus granulosus is the cause of hydatid cysts located frequently in the liver and lungs, but also in the kidneys, bones, spleen, brain and muscles. Cystic echinococcosis is sometimes complicated to treat, requiring radical surgery and prolonged medication. The hydatid cyst in the retroperitoneal space is frequently asymptomatic, unless it grows and produces symptoms caused by high intracystic pressure, secondary infection, wall breaking and allergy. (2) Case Report: We present the case of a 47-year old male patient, admitted for a giant bilobed retroperitoneal hydatid cyst. Following diagnosis, the patient was operated on using an anterior midline abdominal approach. The cyst was inactivated, the contents were evacuated and the cavity was drained and cleaned by opening the cyst in the middle area and at its lower pole, respectively. Subsequently, the cyst required re-installation of the drain. The evolution of the case was finally favorable but confirmed that the postoperative evolution of large hydatid cysts can be unexpected and even followed by complications. (3) Conclusions: For the presented case, the classic surgical method was the appropriate choice, considering the large size of the hydatid cyst. Bilobed cysts and those with calcified walls may cause problems with the spontaneous closing of the remaining cavity. For complicated cysts, the treatment is radical or conservative surgery, while for uncomplicated cysts, minimally invasive treatment is an appropriate choice. Full article

Pentacyclic triterpenes represent an important class of intensively studied substances in the past two decades due to their wide spectrum of pharmacological effects. Even though this class is being thoroughly researched for the development of new drugs, to date, no representative has qualified to become a suitable candidate for various therapies. Although a large part of past and ongoing studies focuses on triterpene chemical derivatization or formulation to increase its bioavailability, other researchers are focused on obtaining semisynthetic derivatives not necessarily with increased hydrophilicity but with a superior biological effect compared to their parent compound. The current review aims to report the biological assessment of several ring-modified pentacyclic triterpene derivative series. Full article

Chronic kidney disease (CKD) affects around 13% of the adult population, has become a considerable concern worldwide, and is characterized by inadequate renal clearance, resulting in the accumulation of various potential toxic compounds. Metabolomics, one of the many important parts of “omics” science, refers to the systematic study of metabolites in a living system and their changes because of pathophysiological and genetic modifications. The use of metabolomics in the nephrology field of research has offered a better understanding of the pathomechanisms of CKD. The most recent technologies used for the evaluation of plasma and urinary metabolites are nuclear magnetic resonance (NMR) and mass spectroscopy (MS). A major research direction of modern medicine is to develop new therapies and new biomarkers for the early diagnosis of patients with CKD. Experimental studies of renal metabolism unequivocally demonstrated that kidney function has a huge impact on several circulating metabolites. Moreover, metabolites themselves appear to have an essential role in CKD pathogenesis/complications, being recognized as potential biomarkers with prognostic, diagnostic, and therapeutic value for the disease. The present paper provides a bird’s eye view on metabolomics and a summary of the most recent studies of metabolomics carried out in patients with CKD. Full article

(1) Background: Meniscal lesions are one of the most prevalent pathologies in orthopedics; meniscal root tears have been recognized as a specific subset with poor mid- to long-term results after standard treatment options (observation, physical therapy, arthroscopic partial meniscectomy) and frequent progression to osteoarthritis. Meniscal root repair has emerged as a new technique with promising results. We present a case report and review the current literature regarding the diagnosis, indications to repair, current techniques, alternatives and expected outcomes. (2) Case report: A 49-year-old woman, with a body mass index of 30 and no significant comorbidities or history of trauma, involved in moderate to heavy physical activity, presented with left knee pain at the internal meniscal line, which worsened over the last 4 months, despite an intra-articular steroid shot. Based on the magnetic resonance imaging (MRI), she was diagnosed with a type 2 medial meniscus posterior root tear and moderate internal compartment chondropathy (Outerbridge 2). She underwent side-to-side repair of the meniscal lesion and reattachment of the root through a bone tunnel over a button. Postoperatively, she was non-weight-bearing (NWB) for 6 weeks and with the knee immobilized at 30° of flexion. At 6 months’ follow-up, the patient was fully ambulant without crutches, with active knee flexion between 0° and 130°. (3) Conclusion: Meniscal root repair is reasonably accessible. It may provide additional benefits over current treatment options when used judiciously and with an adequate surgical technique. Full article

(1) Introduction: Prostate cancer is the second leading cause of cancer-related death in men in developed countries. Due to the existing biomarkers’ limitations, there is a stringent need to develop novel, better non-invasive markers for prostate cancer diagnostic and monitoring. (2) Material and methods: We assessed, by real-time PCR, the expression level of 84 long non-coding RNA (lncRNA) in plasma and the exosomes isolated from prostate cancer patients’ plasma and urine. (3) Results: Only a few lncRNAs were detected in high abundance (Ct between 25 and 30 cycles) across all sample types, the vast majority showing relatively modest levels (Ct > 30 cycles). As expected, plasma and plasma exosomes contain far more lncRNA species than urine, irrespective of whether they originate from patients or controls. We identified two statistically significant dysregulated lncRNAs in prostate cancer samples vs. controls: RBM5-AS1, 2.89 times downregulated in plasma (p = 0.036), and SNHG16, 13.69 times upregulated (p = 0.029) in urine exosomes. (4) Conclusions: These preliminary data need further validation in additional independent, more extensive studies before they can be considered as biomarkers for prostate cancer. Full article

(1) Background: Oronasal communication is described in the scientific literature as a common complication that occurs after a cleft palate surgery. In some cases, it can also be a consequence of oral surgery procedures; the main problem of this type of rare accident is related to the correct healing process and treatment option. (2) Case report: A patient with oronasal communication caused by an unsuccessful attempt of a superior canine odontectomy presented at the Emergency Department of the Oral and Maxillofacial Surgery Hospital, Timișoara. The case management is described from the first consult to one-year follow-up. We consider that this pathology was optimally treated surgically, and the results are more than satisfactory, taking into consideration the high rates of recurrence. (3) Conclusion: This case report can be a useful to a general dentist who is trying to decide whether to perform the canine odontectomy or refer to a specialist surgeon due to the accidents and complications of this procedure. Full article

(1) Background: Complete atrioventricular block is a well-known complication of alcohol ablation as a septal reduction therapy, implemented in selected patients with hypertrophic obstructive cardiomyopathy (HOCM). It usually occurs during or immediately after the intervention. Rare cases of late complete atrioventricular block (CAVB) have been reported, but data are still scarce in the literature regarding this issue. (2) Case report: We report the case of a 70-year-old male patient, with mild aortic stenosis, but with a significantly degenerated valve and perivalvular tissue, and a nonspecific intraventricular conduction delay, which developed intensely symptomatic CAVB, four months after alcohol septal ablation (ASA) for HOCM, along with left ventricular pressure gradient recurrence. Both problems were resolved by implantation of a dual chamber pacemaker, with pacing optimization to a short atrioventricular interval, along with a maximal tolerated betablocker therapy. With the description of the patient’s treatment and evolution in comparison with other reports and studies, this case report highlights the fact that a close clinical, electrical and echocardiographic surveillance is warranted for this kind of patients, as late CAVB may be a life-threatening complication. Previous electrical conduction problems and degenerated aortic valve and perivalvular tissue may be predisposed for this type of complication, independent of betablocker therapy. This treatment has several other beneficial effects and thus it should not be interrupted after the procedure. Full article

(1) Background: Oral mucosal infections are a commonly encountered clinical pathology in patients who consult dentists, mainly for dental diseases. Currently, the involvement of oral and dental infections in cardiovascular and neurological diseases, among others, is widely discussed in the literature. In the present research, we elaborated a comprehensive report on rare oral mucosal infections, including oral syphilis and head and neck tuberculosis. (2) Methods: The research was performed by the authors using three databases (PubMed, Wiley, and ScienceDirect). Scientific articles published from January 2000 to January 2020 were selected and reviewed to assess the epidemiology, symptoms, and diagnosis of oral syphilis and head and neck tuberculosis. (3) Results: Oral syphilis was mainly noticed as ulcers and secondary types of disease. Tuberculosis of the head and neck was most frequently encountered as cervical lymphadenopathy. (4) Conclusions: Rare oral infections diagnosis may be challenging due to their evolving polymorphic clinical appearance and their ability to mimic various diseases in the oral cavity and head and neck area. Full article

(1) Background: Parents play an important role in children’s oral health by contributing to the development of proper oral hygiene and eating behaviors as well as offering the child access to dental services. The aim of this study was the evaluation of parents’ involvement in their child’s visits to the dental office. (2) Methods: The cross-sectional study was conducted in 2020 in Romania on a sample of 105 parents using an online self-administered questionnaire. (3) Results: Only 9.52% of parents brought their children to the dental office for their first visit in their 1st year of life; 51.53% of children visit the dentist at least once a year but for only 42.86% of children, the reason of their last visit was a regular dental check-up. (4) Conclusions: parents underestimate the role of dental service utilization for their children; the first visit to the dental office for most children is at an older age than optimal, the frequency of dental visits is less than recommended, and they are treatment-oriented. Full article